Shandong University of Traditional Chinese Medicine, Jinan, China.
Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
Complement Ther Med. 2024 Oct;85:103081. doi: 10.1016/j.ctim.2024.103081. Epub 2024 Sep 7.
OBJECTIVE: To summarize the current available evidence and to outline recommendations for the future research of acupuncture for patients after percutaneous coronary intervention (PCI). DESIGN: Seven electronic databases were searched: China National Knowledge Infrastructure (CNKI), Wan Fang Database, Chongqing VIP Chinese Science and Technology Periodical Database (VIP), Chinese Biomedical Literature Database (CBM), Cochrane Library, PubMed, and EMBASE. All studies on acupuncture for patients after PCI were included. The search period was from the database establishment to June 13th, 2024. SETTING: Using full-text and Medical Subject Headings (MeSH) searches, two personnel independently screened and checked articles strictly according to the inclusion and exclusion criteria, and they reached an agreement through discussion on articles with different opinions. INTERVENTIONS: Post-PCI acupuncture. MAIN OUTCOME MEASURES: Creating descriptive charts to visually express the research features. RESULTS: 38 eligible studies were included. Their main topic was the use of acupuncture in patients after PCI. The primary focus of these studies was the application of acupuncture in patients post-PCI. The majority of the included articles originated from China, with the majority published in the year 2023. The types of studies encompassed randomized controlled trials (RCTs) (25, 65.8 %), protocols (6, 15.8 %), review articles (6, 15.8 %), and case report (1, 2.6 %). The acupuncture methods utilized varied, with filiform needle therapy being the most common (14, 36.8 %), followed by auricular plaster therapy (7, 18.4 %), thumbtack needle therapy (7, 18.4 %), and eye acupuncture (1, 2.6 %). The acupoints most frequently used were Shenmen (TF4) in the auricular region and Neiguan (PC6). The needle retention time was predominantly 30 min, as reported in nine studies involving filiform needles. In the control groups of the included studies, secondary prevention measures were most commonly employed, appearing in thirteen studies. The Pittsburgh Sleep Quality Index (PSQI) was the most frequently measured outcome, featured in nine studies. Psychological issues were identified as the most prevalent condition following PCI, mentioned in seventeen studies. CONCLUSION: The main focus of this scoping review was on psychological issues, cardiovascular problems, and exercise capacity or quality of life of patients after PCI. The majority of research has concentrated on psychological and cardiovascular issues. However, the outcomes related to varieties of acupuncture therapy methods, acupoints selection, retention time, treatment frequency, and other aspects of acupuncture practice were interconnected and complex within the clinical application of acupuncture. These interconnected elements collectively impacted the treatment of acupuncture in the post-PCI context, making it challenging to reach definitive conclusions. The heterogeneity in acupuncture practices highlighted the need for future research. It is recommended that future studies employ more rigorous designs, standardized methodologies, larger sample sizes, and higher quality to enhance our understanding of acupuncture's role in post-PCI care. This is particularly important for elucidating its potential in addressing psychological and cardiovascular problems, which are critical areas of concern for patients post-PCI. REGISTRATION: This scoping review has been registered in the Open Science Framework Registry (https://doi.org/10.17605/OSF.IO/3HZFW). We drafted this paper following the PRISMA extension for Scoping Reviews (PRISMA-ScR) (https://www.prisma-statement.org/scoping) (Appendix 1).
目的:总结目前关于经皮冠状动脉介入治疗(PCI)后针刺治疗的证据,并为未来的研究提出建议。
设计:检索了 7 个电子数据库:中国知网(CNKI)、万方数据库、重庆维普中文科技期刊数据库(VIP)、中国生物医学文献数据库(CBM)、 Cochrane 图书馆、PubMed 和 EMBASE。纳入所有关于 PCI 后针刺治疗的研究。检索时间从数据库建立到 2024 年 6 月 13 日。
设置:使用全文和医学主题词(MeSH)检索,两名人员严格按照纳入和排除标准进行独立筛选和检查文章,并通过讨论对有不同意见的文章达成一致。
干预措施:PCI 后针刺。
主要观察指标:创建描述性图表,直观表达研究特征。
结果:纳入 38 项符合条件的研究。其主要主题是针刺在 PCI 后患者中的应用。这些研究的主要重点是针刺在 PCI 后患者中的应用。纳入的大多数文章来自中国,其中大部分发表于 2023 年。研究类型包括随机对照试验(RCT)(25 篇,65.8%)、方案(6 篇,15.8%)、综述(6 篇,15.8%)和病例报告(1 篇,2.6%)。使用的针刺方法多种多样,毫针疗法最为常见(14 篇,36.8%),其次是耳贴疗法(7 篇,18.4%)、梅花针疗法(7 篇,18.4%)和眼针疗法(1 篇,2.6%)。最常用的穴位是耳部的神门(TF4)和内关(PC6)。纳入研究中,9 项研究报告了毫针的留针时间,主要为 30 分钟。纳入研究中,对照组多采用二级预防措施,共 13 项。最常测量的结局指标是匹兹堡睡眠质量指数(PSQI),共 9 项。PCI 后最常见的心理问题,共 17 项研究提到。
结论:本范围综述的主要重点是 PCI 后患者的心理问题、心血管问题和运动能力或生活质量。大多数研究都集中在心理和心血管问题上。然而,与各种针刺治疗方法、穴位选择、留针时间、治疗频率等方面相关的结果在针刺的临床应用中是相互关联和复杂的,这些相互关联的因素共同影响了 PCI 后针刺的治疗效果,使得难以得出明确的结论。针刺实践中的异质性突出了未来研究的必要性。建议未来的研究采用更严格的设计、标准化的方法、更大的样本量和更高的质量,以提高我们对针刺在 PCI 后护理中的作用的理解。这对于阐明针刺在解决 PCI 后患者的心理和心血管问题方面的潜在作用尤为重要,这些问题是 PCI 后患者关注的关键领域。
注册:本范围综述已在开放科学框架注册(https://doi.org/10.17605/OSF.IO/3HZFW)。我们按照扩展后的 PRISMA 范围综述(PRISMA-ScR)(https://www.prisma-statement.org/scoping)(附录 1)起草了这篇论文。
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